Organization
KENNEDY MEDICAL GROUP PRACTICE, P.C.D/B/A KENNEDY HEALTH ALLIANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE O'NEIL (CREDENTIALING)
(856) 783-1987
Entity
Organization
Contact information
Practice address
151 FRIES MILL RD, SUITE 400, TURNERSVILLE, NJ 08012
(856) 401-9300
(856) 374-5805
Mailing address
151 FRIES MILL RD, SUITE 400, TURNERSVILLE, NJ 08012
(856) 401-9300
(856) 374-5805
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7650001
—
NJ
Enumeration date
07/14/2006
Last updated
03/27/2015
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